HYPERTRIGLYCERIDAEMIC PANCREATITIS AND DIABETIC KETOACIDOSIS

• Published in: Research and science today no. 2; pp. 125 - 130
• Main Authors: Petre, Raluca, Băleanu, Vlad-Dumitru, Vasile, DăNuţ, Daviţoiu, Dragoş-Virgil, Pascal, Anca-Roxana, Tudor, Cristina-Anca, Pîrvu, Daniel-Cristian
• Format: Journal Article
• Language: English
• Published: Targu-Jiu University Constantin Brancusi of Târgu-Jiu 01.10.2021
• Subjects: Abdomen; Acidosis; Alcohol; Anesthesia; Antibiotics; Anticoagulants; Bicarbonates; Bile ducts; Bilirubin; Cholesterol; Creatinine; Diabetes; Diabetes mellitus; Emergency medical care; Enteral nutrition; Glucose; Heart rate; Hemoglobin; Heparin; Hyperglycemia; Hypocalcemia; Inflammation; Insulin; Ketoacidosis; Ketonuria; Laboratories; Lipase; Metabolic acidosis; Metabolism; Nausea; Pain; Pancreatitis; pH effects; Plasmapheresis; Systemic inflammatory response syndrome; Thyroiditis; Urea; Urine; Ventilators; Vomiting
• ISSN: 2247-4455; 2285-9632
• DOI: 10.38173/RST.2021.22.2.12.125-130

Laboratory parameters showed severe metabolic acidosis with high anion gap , pH 7.07, bicarbonate 8 mmol/l (normal range 22-28 mmol/l), anion gap 20 mmol/l (normal range 4-12 mmol/l), BE -22 mmol/l hyperglycemia, glucose blood level 727 mg/dl (normal range70-106 mg/dl), lipase 6157 U/l (normal range 73-393 U/l), amylase 822 U/l (normal range 15-115 U/l), severe HTG, TG 4491 mg/dl (normal range 30-150 mg/dl), hypocalcemia 6.1 mg/dl (normal range 8.2-10.7 mg/dl), Na 116 mmol/l (normal range 135-150 mmol/l), K 5.2 mmol/l (normal range 3.5-5.2 mmol/l), LDH 902 U/l (normal range 84-227 U/l), creatinine 1.59 (normal range 0.5-1.5 mg/dl), AST 117 (normal range 2-40 U/l), ALT 88 U/l, creatinine 1.59 mg/dl . Given the high level of TG and the development of respiratory failure and SIRS ( Systemic inflammatory response syndrome) in a patient with HTG-AP we performed a plasmapheresis session using human albumin 5% and heparin anticoagulation.The TG level after plasmapheresis was 345 mg/dl. CASE 2 A 45 year old woman with history of autoimmune thyroiditis without home treatment, no alcohol consumpton came to the emergency department for severe upper abdominal pain, nausea and vomiting started 4 days earlier when she performed a glucose strip test at home and found a high glucose blood level (345 mg/dl) but she did not go to the hospital. Laboratory exam pH 7.2, bicarbonat 7.2 mmol/l, BE -20 mmol/l, anion gap 23 mmol/l, hyperglycemia (508 mg/dl), TG 1379 mg/dl , cholesterol 411 mg/dl, creatinine 1,63 mg/dl, urea 29 mg/dl K 5.78 mmol/l, Na 123 mmol/l, total calcium 7 mg/dl, ALT 59 U/l, AST 49 U/l, total bilirubin 0,4 mg/dl, lipase 2329 U/l, amylase 1529 U/l, white blood cell 14400/ μL. Urine analysis revealed a urine glucose of 500mg/dL and ketonuria (30mg/dL), density 1030.